Behavioral & Community Health
Permanent URI for this communityhttp://hdl.handle.net/1903/2271
Prior to January 24, 2011, this unit was named the Department of Public & Community Health.
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Item Meditation, Flow, and Heavy Social Alcohol Use among College Students(1992) Francis, Timothy Lewis; Iso-Ahola, Seppo; Recreation; Digital Repository at the University of Maryland; University of Maryland (College Park, Md)The basis for this study was an experiment designed to explore the effectiveness of various meditation practices and choice and combination of such, regardless of focus, in achieving more drug-free flow experiences, longer periods of meditation adherence, and decreases in heavy social alcohol use among college students. The study also examined the hypothesis that higher frequencies of reported flow in meditation were associated with lower levels of reported alcohol use and higher frequencies of post-training meditation practice, regardless of meditation focus. The interaction of several critical intervening variables not comprehensively addressed in previous studies on meditation and substance abuse, including experimental expectancy and demand, previous alcohol use, hypnotic susceptibility, and personality was checked and controlled for in this experiment. After receiving basic meditation training, 53 subjects with drinking rates typical of heavy social alcohol users were randomly assigned to one of four meditation groups or to a control group. Three groups practiced only one of three foci--object focused, visualization, or mindfulness. The fourth group chose their meditation foci each day from any of the above three types. The fifth (control) group practiced an attention Placebo activity. Four weeks of daily diaries following meditation were used to determine the level of the dependent variables--frequency of flow and amount of alcohol use. Subjects then reported post-required meditation frequency and alcohol use through four weekly phone interviews. MANOVA, ANOVA, and zero-order correlations were employed to analyze the relationships between the variables. No one specific meditation focus nor having choice and combination of foci, was indicated to result in significantly more flow, less alcohol use, or longer mediation adherence. There was a slight indication that higher frequencies of flow were related to higher frequencies of meditation practice, but no indication that more flow was related to less alcohol use. These results should be interpreted with caution for several reasons, including the short meditation training and practice period, low reliability and validity of subject reports, and problems associated with large variations in drinking rates. Future research on these issues should refine training and testing methods so that better treatment methods can be found.Item Resting Metabolic Rates in Child-Onset and Adult Obese Women(1989) Summerfield, Liane M.; Gold, Robert; Health Education; Digital Repository at the University of Maryland; University of Maryland (College Park, Md)This study investigated differences in resting metabolic rate (RMR) between obese nonobese females and between females with adult and childhood onset of obesity. Subjects were 18 healthy, Caucasian women, ages 20-38 (M=28.16), 6 from each of 3 groups: nonobese with no history of obesity (M-18.53% fat), child-onset obese (COO) (M=41.00% fat), and adult-onset obese (AOO) (M=37.8% fat). Subjects were nonsmokers, weight-stable for at least 3 months prior to the study, and not following a low-calorie diet. All obese subjects had lower-body obesity (waist/hip girth ratio < .80). Subjects underwent three measures: RMR by indirect calorimetry, residual lung volume, and hydrostatic weighing. In addition, a questionnaire elicited information about weight history, educational level, occupation, frequency of exercise, and activity level. When data from the 12 obese subjects were combined, RMR per kg body weight (RMR/BW) was significantly lower in the obese (18.47 kcal/kg/day) than the nonobese (22.94 kcal/kg/day). The obese subjects also had significantly lower RMR per kg fat mass (RMR/FM) than the nonobese. When data from COO and AOO subjects were analyzed separately, COO were found to have significantly lower RMR/FM than the nonobese. COO and AOO subjects did not differ statistically in absolute RMR, RMR/BW, RMR/FM, or RMR/FFM, although COO had lower values on all measures. Multiple regression analysis indicated that, in all groups, more of the variance in RMR was explained when the variables, FM and FFM. However, the effect of activity and exercise on explained variance in RMR was much smaller in COO women.Item Mature Humor or Immature Wit?: The Interaction Effects of Laughter Humor Production, Humor Aprreciation, and Defensive Coping Strategies on Emotional and Physical Stress Symptoms(1993) Carey, Coral Sue; Beck, Kenneth; Health Education; Digital Repository at the University of Maryland; University of Maryland (College Park, Md)The purpose of this study was to investigate the use of humor and mirth in stress management by an adult population with the potential for high occupational stress. The primary objective was to test the efficacy of each of the humor components (laughter, humor appreciation, and humor production) in mediating the stress response while controlling for other coping strategies. Two new instruments were developed for use in this study; (1) the Emotional Coping Scale to assess laughter and humor production, (2) the Stress Mediators Inventory to measure mature coping and immature defense strategies. Over 2,000 employees of the University of Maryland College Park campus were surveyed, using random probability sampling, stratifying by the 9 EEO occupational categories, such as administration and professionals. Questionnaires were dispersed through inter-campus mail. Results from the 754 returned questionnaires were analyzed with the appropriate multivariate techniques. Males, minorities, faculty skilled crafts, service maintenance, and fellowship students were under-represented. With these limitations in mind, results suggest: (1) men scored significantly higher than women on all three components of humor, as measured by this study; (2) humor appreciation and laughter, but not humor production were significantly related to emotional stress, while only laughter was related to physical stress symptoms, such that those with higher humor scores showed lower stress scores; (3) the type of humor response (self directed, other directed, or neutral) as related to stress symptoms; (4) the interaction effect between humor variables and immature defense strategies for coping with stress did not significantly predict stress; (5) there appears to be a stress and coping profile that is significantly different for many of the 9 occupational groups, such that those with high demand and low control jobs show higher stress scores.Item Psychometric Assessment of Two New Self-Rating Depression Scales: The Correa-Barrick Depression Scale(1994) Barrick, Christina Barrett; Clearwater, Harvey E.; Health Education; Digital Repository at the University of Maryland; University of Maryland (College Park, Md)Depression is a prevalent condition that is responsive to treatment. Efforts to screen and educate the public on depression are beneficial. The purpose of this investigation was to assess the psychometric properties of two new self-rating depression scales, the Schiraldi Depression Check-up (DC) and the Correa-Barrick Depression Scale (CBDS), based upon classical test theory and comparisons to published scales: the Beck Depression Inventory (BDI) and the Inventory for Depressive Symptomatology, Self-Report (IDS-SR). The study was conducted on a total of 387 participants. There were two convenience samples used. Sample I was composed of 337 faculty and staff from a metropolitan comprehensive university. A subset of Sample I was composed of 203 faculty and staff. Sample II included 50 outpatients diagnosed with depression under the treatment of a board certified psychiatrist. Correlation coefficients for the DC and CBDS with the BDI were r = . 75 and r = . 71, respectively. Cronbach alpha coefficients for the DC and CBDS in the patient sample were r = .95 and r = .96, respectively. Correlation coefficients for the IDS-SR with the DC and the CBDS in the patient sample were r = .85 and r = .81, respectively. Two-week test-retest correlation coefficients in the university sample for the DC and CBDS were r = .81 and r = . 70, respectively. Factor analysis for the DC revealed a threefactor structure: "Cognitive-Emotional Disturbance," " Psychophysiological Symptoms," and "Physiological Symptoms." Factor analyses for the CBDS revealed a four-factor structure: "Cognitive-Emotional Disturbance," "General Outlook," "Physiological Symptoms," and "Sensory/Perceptual Disturbance." Discriminant analysis did not support the Depression Check-up or the Correa-Barrick Depression Scale in discriminating between the university and patient samples. There were several conclusions from this study. Findings provided preliminary evidence for the validity and reliability of the Depression Check-up and the Correa-Barrick Depression Scale in measuring depression in an adult population. The findings that sensory-perceptual disturbance may be an additional variable in depression and that a single-factor structure emerged for "emotional-cognitive disturbance" was discussed as well as implications for health education theory, practice, and research.Item The relationship between unsupervised time after school and physical activity in adolescent girls(Springer Nature, 2006-07-31) Rushovich, Berenice R; Voorhees, Carolyn C; Davis, CE; Neumark-Sztainer, Dianne; Pfeiffer, Karin A; Elder, John P; Going, Scott; Marino, Vivian GRising obesity and declining physical activity levels are of great concern because of the associated health risks. Many children are left unsupervised after the school day ends, but little is known about the association between unsupervised time and physical activity levels. This paper seeks to determine whether adolescent girls who are without adult supervision after school are more or less active than their peers who have a caregiver at home. A random sample of girls from 36 middle schools at 6 field sites across the U.S. was selected during the fall of the 2002–2003 school year to participate in the baseline measurement activities of the Trial of Activity for Adolescent Girls (TAAG). Information was collected using six-day objectively measured physical activity, self-reported physical activity using a three-day recall, and socioeconomic and psychosocial measures. Complete information was available for 1422 out of a total of 1596 respondents. Categorical variables were analyzed using chi square and continuous variables were analyzed by t-tests. The four categories of time alone were compared using a mixed linear model controlling for clustering effects by study center. Girls who spent more time after school (≥2 hours per day, ≥2 days per week) without adult supervision were more active than those with adult supervision (p = 0.01). Girls alone for ≥2 hours after school, ≥2 days a week, on average accrue 7.55 minutes more moderate to vigorous physical activity (MVPA) per day than do girls who are supervised (95% confidence interval ([C.I]). These results adjusted for ethnicity, parent's education, participation in the free/reduced lunch program, neighborhood resources, or available transportation. Unsupervised girls (n = 279) did less homework (53.1% vs. 63.3%), spent less time riding in a car or bus (48.0% vs. 56.6%), talked on the phone more (35.5% vs. 21.1%), and watched more television (59.9% vs. 52.6%) than supervised girls (n = 569). However, unsupervised girls also were more likely to be dancing (14.0% vs. 9.3%) and listening to music (20.8% vs. 12.0%) (p < .05). Girls in an unsupervised environment engaged in fewer structured activities and did not immediately do their homework, but they were more likely to be physically active than supervised girls. These results may have implications for parents, school, and community agencies as to how to structure activities in order to encourage teenage girls to be more physically active.Item Girls' perception of physical environmental factors and transportation: reliability and association with physical activity and active transport to school(Springer Nature, 2006-09-14) Evenson, Kelly R; Birnbaum, Amanda S; Bedimo-Rung, Ariane L; Sallis, James F; Voorhees, Carolyn C; Ring, Kimberly; Elder, John PPreliminary evidence suggests that the physical environment and transportation are associated with youth physical activity levels. Only a few studies have examined the association of physical environmental factors on walking and bicycling to school. Therefore, the purpose of this study was (1) to examine the test-retest reliability of a survey designed for youth to assess perceptions of physical environmental factors (e.g. safety, aesthetics, facilities near the home) and transportation, and (2) to describe the associations of these perceptions with both physical activity and active transport to school. Test and retest surveys, administered a median of 12 days later, were conducted with 480 sixth- and eighth-grade girls in or near six U.S. communities. The instrument consisted of 24 questions on safety and aesthetics of the perceived environment and transportation and related facilities. Additionally, girls were asked if they were aware of 14 different recreational facilities offering structured and unstructured activities, and if so, whether they would visit these facilities and the ease with which they could access them. Test-retest reliability was determined using kappa coefficients, overall and separately by grade. Associations with physical activity and active transport to school were examined using mixed model logistic regression (n = 610), adjusting for grade, race/ethnicity, and site. Item-specific reliabilities for questions assessing perceived safety and aesthetics of the neighborhood ranged from 0.31 to 0.52. Reliabilities of items assessing awareness of and interest in going to the 14 recreational facilities ranged from 0.47 to 0.64. Reliabilities of items assessing transportation ranged from 0.34 to 0.58. Some items on girls' perceptions of perceived safety, aesthetics of the environment, facilities, and transportation were important correlates of physical activity and, in some cases, active transport to school. This study provides some psychometric support for the use of the questionnaire on physical environmental factors and transportation for studying physical activity and active transport to school among adolescent girls. Further work can continue to improve reliability of these self-report items and examine their association of these factors with objectively measured physical activity.Item Identifying the Tuskegee Syphilis Study: implications of results from recall and recognition questions(Springer Nature, 2009-12-16) Katz, Ralph V; Jean-Charles, Germain; Green, B Lee; Kressin, Nancy R; Claudio, Cristina; Wang, MinQi; Russell, Stefanie L; Outlaw, JasonThis analysis assessed whether Blacks, Whites and Puerto-Rican (PR) Hispanics differed in their ability to identify the Tuskegee Syphilis Study (TSS) via open-ended questions following lead-in recognition and recall questions. The Tuskegee Legacy Project (TLP) Questionnaire was administered via a Random-Digit Dial (RDD) telephone survey to a stratified random sample of Black, White and PR Hispanic adults in three U.S. cities. The TLP Questionnaire was administered to 1,162 adults (356 African-Americans, 313 PR Hispanics, and 493 non-Hispanic Whites) in San Juan, PR, Baltimore, MD and New York City, NY. Recall question data revealed: 1) that 89% or more of Blacks, Whites, and PR Hispanics were not able to name or definitely identify the Tuskegee Syphilis Study by giving study attributes; and, 2) that Blacks were the most likely to provide an open-ended answer that identified the Tuskegee Syphilis Study as compared to Whites and PR Hispanics (11.5% vs 6.3% vs 2.9%, respectively) (p ≤ 0.002). Even when probed by a recognition question, only a minority of each racial/ethnic group (37.1%, 26.9%, and 8.6%, for Blacks, Whites and PR Hispanics, respectively) was able to clearly identify the TSS (p < 0.001). The two major implications of these findings for health disparity researchers are 1) that it is unlikely that detailed knowledge of the Tuskegee Syphilis Study has any current widespread influence on the willingness of minorities to participate in biomedical research, and 2) that caution should be applied before assuming that what community leaders 'know and are aware of' is equally 'well known' within their community constituencies.Item An oral health literacy intervention for Indigenous adults in a rural setting in Australia(Springer Nature, 2012-06-20) Parker, Eleanor J; Misan, Gary; Chong, Alwin; Mills, Helen; Roberts-Thomson, Kaye; Horowitz, Alice M; Jamieson, Lisa MIndigenous Australians suffer substantially poorer oral health than their non-Indigenous counterparts and new approaches are needed to address these disparities. Previous work in Port Augusta, South Australia, a regional town with a large Indigenous community, revealed associations between low oral health literacy scores and self-reported oral health outcomes. This study aims to determine if implementation of a functional, context-specific oral health literacy intervention improves oral health literacy-related outcomes measured by use of dental services, and assessment of oral health knowledge, oral health self-care and oral health- related self-efficacy. This is a randomised controlled trial (RCT) that utilises a delayed intervention design. Participants are Indigenous adults, aged 18 years and older, who plan to reside in Port Augusta or a nearby community for the next two years. The intervention group will receive the intervention from the outset of the study while the control group will be offered the intervention 12 months following their enrolment in the study. The intervention consists of a series of five culturally sensitive, oral health education workshops delivered over a 12 month period by Indigenous project officers. Workshops consist of presentations, hands-on activities, interactive displays, group discussions and role plays. The themes addressed in the workshops are underpinned by oral health literacy concepts, and incorporate oral health-related self-efficacy, oral health-related fatalism, oral health knowledge, access to dental care and rights and entitlements as a patient. Data will be collected through a self-report questionnaire at baseline, at 12 months and at 24 months. The primary outcome measure is oral health literacy. Secondary outcome measures include oral health knowledge, oral health self-care, use of dental services, oral health-related self-efficacy and oral health-related fatalism. This study uses a functional, context-specific oral health literacy intervention to improve oral health literacy-related outcomes amongst rural-dwelling Indigenous adults. Outcomes of this study will have implications for policy and planning by providing evidence for the effectiveness of such interventions as well as provide a model for working with Indigenous communities.Item Role of life events in the presence of colon polyps among African Americans(Springer Nature, 2013-06-12) Ashktorab, Hassan; Namin, Hassan Hassanzadeh; Taylor, Teletia; Williams, Carla; Brim, Hassan; Mellman, Thomas; Shokrani, Babak; Holt, Cheryl L; Laiyemo, Adeyinka O; Nouraie, MehdiAfrican Americans have disproportionately higher incidence and death rates of colorectal cancer among all ethnic groups in the United States. Several lifestyle factors (e.g. diet, physical activity and alcohol intake) have been suggested as risk factors for colorectal cancer. Stressful life events have also been identified as risk factors for colorectal cancer. The association between stressful life events and colon polyps, which are precursors of colorectal cancer, has yet to be determined. We aimed to evaluate the relationship between stressful life events and the presence of colon polyps and adenomas in African American men and women. In this cross-sectional study, 110 participants were recruited from a colon cancer screening program at Howard University Hospital. Participants completed an 82-item Life Events Questionnaire (Norbeck 1984), assessing major events that have occurred in the participants’ life within the past 12 months. Participants also reported whether the event had a positive or negative impact. Three scores were derived (total, positive, and negative). Total life events scores were higher (Median [M] = 29 and Interquartile range [IQR] = 18-43) in patients with one or more polyps compared to patients without polyps (M, IQR = 21,13-38; P = 0.029). Total, positive or negative Life Events scores did not differ significantly between normal and adenoma patients. Total, negative and positive Life Events scores did not differ between patients who underwent diagnostic colonoscopy (symptomatic) and patients who underwent colonoscopy for colon cancer screening (asymptomatic) and patients for surveillance colonoscopies due to a personal history of colon polyps. Linear regression analysis indicated that male gender is associated with 9.0 unit lower total Life Events score (P = 0.025). This study suggests that patients who experienced total life events may be at higher risk of having colon polyps and adenomas which indicates an association between stress and the development of colorectal polyps.Item Hepatitis B screening among Chinese Americans: a structural equation modeling analysis(Springer Nature, 2015-03-08) Ma, Grace X; Zhang, Guo Yolanda; Zhai, Shumenghui; Ma, Xiang; Tan, Yin; Shive, Steven E; Wang, Min QiHepatitis B Virus (HBV) disproportionately affects new immigrants from endemic regions such as China. Untreated infections increase health risks for liver diseases including cancer. Yet most of those infected are unaware of their disease limiting prevention and early treatment options. The purpose of this community based study was to evaluate a heuristic model identifying factors contributing to Hepatitis B (HBV) screening among Chinese Americans. A cross-sectional design included a sample of 924 Chinese men and women 18 years of age and older of which 718 had complete data for final analysis. Confirmatory factor analysis verified conceptual indicators including access/satisfaction with health care and enabling, predisposing, cultural, and health belief factors. Structural equation modeling was used to identify direct and indirect predictors of Hepatitis B screening. Bivariate analysis revealed that Chinese respondents who were never screened for HBV were significantly more likely to be below age 40 (69.8%), male (69.2%), had less than a high school education (76.4%), with less than 6 years living in the US (72.8%) and had no health insurance (79.2%). The final model identified enabling factors (having health insurance, a primary health care provider to go to when sick and more frequent visits to a doctor in the last year) as the strongest predictor of HBV screening (coefficient = 0.470, t = 7.618, p < .001). Predisposing factors (education variables) were also significantly related to HBV screening. Cultural factors and Satisfaction with Health care were associated with HBV screening only through their significant relationships with enabling factors. The tested theoretical model shows promise in predicting HBV testing among Chinese Americans. Increasing access to health care by expanding insurance options and improving culturally sensitivity in health systems are critical to reach new immigrants like Chinese for HBV screening. Yet such strategies are consistent with DHHS Action plan for the Prevention and Treatment of Viral Hepatitis. Implementing community-based strategies like partnering with relevant Community-Based Organizations are important for meeting HBV policy targets.